Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 02692 | Date 27/12/2018 |
| Token No | SM/18-19/7327 24/01/2019 | Serial | 014 Last Visit: 20/03/2021 |
| Patient Name | Miss SOUMI DAS | Contact No | 8420165898 |
| Address | 66 CHATRA DHARMOTALA LANE, SERAMPORE | Age | 5.7 YRS Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 19 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||